losartan - oral, Cozaar

WARNING: This drug can cause serious (possibly fatal) harm to an unborn baby if used during pregnancy. Therefore, it is important to prevent pregnancy while taking this medication. Consult your doctor for more details and to discuss the use of reliable forms of birth control while taking this medication. If you are planning pregnancy, become pregnant, or think you may be pregnant, contact your doctor immediately.

USES: Losartan is used to treat high blood pressure (hypertension) and to help protect the kidneys from damage due to diabetes. It is also used to lower the risk of strokes in patients with high blood pressure and an enlarged heart. Lowering high blood pressure helps prevent strokes Femalegra, heart attacks, and kidney problems. Losartan belongs to a class of drugs called angiotensin receptor blockers. It works by relaxing blood vessels so that blood can flow more easily.OTHER This section contains uses of this drug that are not listed in the approved professional labeling for the drug but that may be prescribed by your health care professional. Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional.This drug may also be used to treat heart failure.

HOW TO USE: Read the Patient Information Leaflet if available from your pharmacist before you start taking losartan and each time you get a refill. If you have any questions, ask your doctor or pharmacist.Take this medication by mouth as directed by your doctor, usually once daily with or without food. The dosage is based on your medical condition and response to treatment.If you are using the liquid form of this medication, shake the bottle well before each dose. Carefully measure the dose using a special measuring device/spoon. Do not use a household spoon because you may not get the correct dose.Use this medication regularly to get the most benefit from it. To help you remember, take it at the same time each day. It is important to continue taking this medication even if you feel well. Most people with high blood pressure do not feel sick.This product may affect your potassium levels. Before using potassium supplements or salt substitutes that contain potassium, consult your doctor or pharmacist.Tell your doctor if your condition does not improve or if it worsens (for example, your blood pressure readings increase).

SIDE EFFECTS: Dizziness or lightheadedness may occur as your body adjusts to the medication. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if any of these unlikely but serious side effects occur: fainting, slow/irregular heartbeat, unusual decrease in the amount of urine.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

PRECAUTIONS: Before taking losartan, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney disease, liver disease.This drug may make you dizzy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Limit alcoholic beverages.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).This medication is not recommended for use during pregnancy due to the risk for harm to an unborn baby. Consult your doctor for more details. (See also Warning section.)It is unknown if this drug passes into breast milk. Consult your doctor before breast-feeding.

Cozaar (losartan)

How does it work?

Cozaar tablets contain the active ingredient losartan potassium, which is a type of medicine called an angiotensin II antagonist. It works by preventing the action of a hormone in the body called angiotensin II.

Angiotensin II normally acts on special receptors in the body Vogirax, with two main results. Firstly, it causes the peripheral blood vessels to narrow, and secondly, it stimulates the production of another hormone called aldosterone. Aldosterone causes salt and water to be retained by the kidneys, which increases the volume of fluid in the blood vessels.

Losartan blocks the receptors that angiotensin II acts on, and so prevents its actions. The main result of this is that the peripheral blood vessels are allowed to widen, which means that there is more space and less resistance in these blood vessels. This is the main mechanism by which the pressure in the blood vessels is lowered.

Blocking the actions of angiotensin II also reduces the action of aldosterone on the kidneys. The result of this is an increase in the amount of fluid removed from the blood by the kidneys. This decreases the amount of fluid in the blood vessels, which also lessens the resistance and pressure in the blood vessels.

The combined overall effect of these changes is to lower the blood pressure, hence losartan is used to treat high blood pressure.

Losartan has been shown to reduce the risk of stroke in people who have high blood pressure together with an enlargement in the left side of their heart (left ventricular hypertrophy). People with both these conditions may therefore be prescribed losartan to reduce their chances of experiencing a stroke. However, this medicine is not effective for this particular use in black patients.

Losartan has also been shown to delay the progression of kidney disease in people with type 2 diabetes who have related kidney complications. If you have diabetic kidney disease you may be prescribed losartan for this reason, regardless of whether or not you also have high blood pressure.

What is it used for?

• High blood pressure (hypertension)
• Reducing risk of stroke in people with high blood pressure and an enlarged heart (left ventricular hypertrophy)
• Delaying progression of kidney disease in people with type 2 diabetes and kidney complications (diabetic nephropathy/macroalbuminuria).

Warning!

• Dizziness and weariness may occasionally occur during treatment with blood pressure lowering medicines. This may be made worse by drinking alcohol. If you are affected, caution is required when driving or operating machinery.
• You should have regular blood tests to monitor the amount of potassium in your blood while you are taking this medicine, particularly if you are elderly or have any problems with your kidneys.

Use with caution in

• Elderly people over 75 years of age
• Decreased fluid volume in the body, eg due to diuretic therapy, low salt diet, kidney dialysis, diarrhoea, vomiting, dehydration
• History of decreased liver function
• Moderate to severely decreased kidney function
• Narrowing of the artery which supplies blood to the kidneys (renal artery stenosis)
• People who have had a kidney transplant
• Severe heart failure
• Heart disease characterised by thickening of the internal heart muscle and a blockage inside the heart (hypertrophic obstructive cardiomyopathy)
• Narrowing of one of the valves in the heart (mitral valve stenosis)
• Narrowing of the main artery of the body (aortic stenosis)
• History of swelling of the lips, face or tongue (angioedema) caused by an ACE inhibitor or other medicine.

Not to be used in

• Pregnancy
• Breastfeeding.

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.

If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and Breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

• This medicine should not be used during pregnancy as it may be harmful to the developing foetus. You should use adequate contraception to avoid getting pregnant while taking this medicine. Seek medical advice from your doctor. If you get pregnant during treatment you should stop taking this medicine immediately and consult your doctor.
• It is not known whether this medicine passes into breast milk. Breastfeeding mothers should either stop treatment during the time that they are breastfeeding, or not breastfeed and continue treatment. This will depend on how important the medicine is for the mother's health. Seek medical advice from your doctor.

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

• Dizziness
• Weakness or loss of strength (asthenia)
• Fatigue
• Balance problems involving the inner ear (vertigo)
• Low blood pressure (hypotension)
• High blood potassium level (hyperkalaemia)
• Diarrhoea
• Low red blood cell count (anaemia) or platelet count (thrombocytopenia)
• Inflammation of the liver (hepatitis)
• Alteration in results of liver function tests
• Migraine
• Pain in the muscles and joints
• Rash or itching
• Cough
• Severe swelling of lips, face or tongue (angioedema)

The side effects listed above may not include all of the side effects reported by the drug's manufacturer.

For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

How can this medicine affect other medicines?

It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to ensure that thecombination is safe.

If you are already taking a high dose of a diuretic medicine, eg furosemide, your doctor may need to reduce its dose before you start this medicine, to avoid causing a large drop in blood pressure that might result in dizziness or fainting.

Losartan may increase the amount of potassium in your blood. If this medicine is taken with other medicines that can increase blood potassium, this effect may be enhanced. Such medicines include the following and these should generally be avoided while you are taking losartan:

• non-steroidal anti-inflammatory drugs, eg indometacin, diclofenac, ibuprofen
• potassium-sparing diuretics (eg spironolactone, triamterene, amiloride)
• potassium supplements
• potassium containing salt substitutes.

Losartan may increase blood levels of the medicine lithium. If you are taking lithium and start treatment with losartan, you should let your doctor know if you experience any signs that your lithium level is increasing, for example: loss of appetite, diarrhoea, vomiting, blurred vision, muscle weakness, lack of co-ordination, drowsiness, tremor, unsteadiness, muscle twitching, ringing in the ears or confusion. Your doctor will need to check your lithium level.

Non-steroidal anti-inflammatory drugs (NSAIDs), eg indometacin, diclofenac, ibuprofen, may oppose the blood pressure lowering effect of losartan and may increase the risk of side effects on the kidneys.

Rifampicin may reduce the blood level and effect of losartan.

Other medicines containing the same active ingredient

There are currently no other medicines available in the UK that contain losartan as the sole active ingredient.

Cozaar-comp contains losartan in combination with the diuretic hydrochlorothiazide.